Nana Odoom, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

DS039358 Issued in PA

Practice address

200 Bent Creek Blvd Ste 3
Mechanicsburg, PA 17050-1938

Phone

(717) 589-4500

Fax

(717) 207-7060

NPI assigned

Aug 28, 2012

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Smilehaus Pediatric Dentistry, PLLC

  • Pediatric Dentistry
  • Mechanicsburg, PA
  • NPI 1417612573
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1346112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1629326319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "417 OLD FARM LN STE B-3A",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170504117",
            "telephone_number": "571-225-7921"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BENT CREEK BLVD STE 3",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170501938",
            "telephone_number": "717-589-4500",
            "fax_number": "717-207-7060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ODOOM",
        "first_name": "NANA",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-08-28",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "PA",
            "license": "DS039358",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Occupational Health Centers of the Southwest P.a.
• Occupational Health Centers of the Southwest P.a.
• Occupational Health Centers of the Southwest P.a.
• Occupational Health Centers of the Southwest, P.a.
• Charles Chinakwu Odenigbo, M.D.
• Oemautospace LLC
• Jade Ogundere
• Cindy Ojevwe, MD
• Lynn Okuley, CPM
• Justine Okurowski

• Dentist in Mechanicsburg, PA
• Providers in Mechanicsburg, PA by specialty
• Dentist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.